Socioeconomic Status and Cerebral Palsy Outcomes in Children: A Systematic Review

Abstract

Context: Cerebral palsy (CP) is the leading cause of lifelong physical disability in childhood. Increasing evidence suggests that socioeconomic status (SES) may influence the risk of CP through multiple biological, environmental, and healthcare-related pathways. However, findings remain inconsistent because studies have used diverse socioeconomic indicators, methodological approaches, and analytical strategies. This systematic review synthesized contemporary evidence on the association between socioeconomic status and the risk of CP in children. Evidence Acquisition: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. We conducted a comprehensive literature search in PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between January 2010 and January 2026. We included observational and population-based studies examining the association between individual- or area-level socioeconomic status and the risk of cerebral palsy (CP) in children. Two reviewers independently extracted data, assessed study quality using validated appraisal tools, and synthesized the findings narratively due to methodological heterogeneity. Results: Twelve studies from Europe, North America, and Asia consistently showed that socioeconomic disadvantage was associated with a higher risk or prevalence of cerebral palsy (CP). Parental education and area-level deprivation were the strongest and most consistent predictors, whereas evidence for household income was less consistent. Socioeconomic disadvantage was also associated with more severe neurological impairment, and these associations often persisted after adjustment for perinatal factors, suggesting an independent contribution of SES to CP risk.